Labor and delivery nurses (L&D), also known as obstetric nurses (OB), are an integral part of the care team responsible for caring for the pregnant patient and child. Though the labor and delivery nurse job description may vary depending on hospital location and size, most labor and delivery RNs will work with women in triage, antepartum mothers, intrapartum mothers, surgical patients, and postpartum mother/baby couplets.
In the article we will explore the following:
- What does a labor and delivery nurse do?
- What is the workplace like?
- What is the salary and job outlook for labor and delivery nurses?
- How do you become a labor and delivery nurse?
- What are some continuing education opportunities?
What does a labor and delivery nurse do?
L&D nurses have many roles. The following are just some of the jobs L&D may perform:
- Assess patients in triage for preterm labor, active labor, rupture of waters, pregnancy complications, or co-existing issues
- Assist in maintaining pregnancy in antepartum mothers
- Fetal assessment and monitoring
- Maternal physical assessment(s)
- Manage patients in labor, including induction assistance, epidural assistance, pain management, education, and delivery support
- Assist and circulate in operating room for cesarean sections, tubal, and emergency obstetric and gynecological procedures
- Medication administration and immunizations
- Patient education related to medications, labor, pushing, delivering, and postpartum care of mother and baby
- Newborn care and assessment for healthy infant
- Breastfeeding and postpartum support/management
- Charting via electronic medical records
- Assist with fetal demise
- Collaboration with care management team, including anesthesiologist, physician or midwife, lactation nurse, and charge nurse
Associated care team
Though L&D nurses have a lot of autonomy, they still work intimately with a variety of different providers and individuals. The L&D nurse is responsible for updating and communicating with the patient’s OBGYN/midwife, the charge nurse, the anesthesiologist (or certified registered nurse anesthetist (CRNA), the lactation nurse, the delivery nurse (if there is one), the neonatal nurse practitioner (NNP) and the family.
What is the workplace like?
The most commonplace of work for an L&D nurse is an acute care hospital. Many hospitals have units specifically for the pregnant population. In one of these units, L&D nurses may find themselves working in triage rooms, antepartum rooms, the operating room, the labor room, the infant nursery, or the postpartum rooms. Shifts are commonly 8-hours, 10-hours, or 12-hours. If a nurse does not work in a maternity-specific unit, they may find that they float around the hospital, working with both pregnant patients and non-pregnant patients.
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What is the salary and job outlook for labor and delivery nurse?
Per the U.S. Bureau of Labor Statistics (BLS), the 2018 median pay for a registered nurse was $71,730/year. The BLS also expects the demand for nurses to grow at a rate of 12% (through 2028), which is much faster than the average for all occupations. Note that these numbers are not specific to the L&D specialty, nor do they account for geographical location, nurse level of education, traveling nurses, or any additional credentials or certifications the nurse professional holds. Each of these factors can have a significant impact on nurse salary.
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How do you become a labor & delivery nurse?
Currently, the Institute of Medicine (IOM) has a 2020 goal that 80% of registered nurses (RN) be bachelor’s prepared professionals. While the United States continues to work towards that goal, there are currently two common educational paths to professional RN practice.
Associates Degree Nurse (ADN)
At the minimum, one must achieve an ADN and pass the NCLEX-RN exam before being eligible for an RN license. ADN programs typically take two years to complete (after two years of the appropriate prerequisites). ADN programs are usually offered through community colleges and include coursework online, in the classroom, lab work, clinical rotations, and practicum experiences.
Bachelor of Science in Nursing (BSN)
To maintain a competitive advantage, as well as meet the IOM mandate, most RNs pursue a BSN for nursing practice. BSN programs usually take four years to complete. There are also “bridge” programs, such as the ADN to BSN, which take anywhere from 12-24 months, which allow a student to move from an ADN to a BSN in less time. BSN programs are offered at brick and mortar campuses and online. Much like an ADN program, they are a combination of classroom work, lecture, labor work, clinical experiences, and practicums.
Master of Science in Nursing (MSN)
An MSN is not required for professional L&D nursing practice. However, many nurses choose to complete an RN to MSN bridge program or work directly towards an MSN, as this education opens up leadership, education, and administrative nursing opportunities.
What are some continuing education opportunities?
Internships & practicums
If possible, a student who desires to work in obstetrics should seek out an obstetric experience for their senior/final practicum. These practicum experiences are a chance to apply what has been learned in school, as well as dive deeper into the specific area a student believes they’d like employment.
Labor and delivery nurse certifications
There are three certifications many L&D RNs (or those who desire an L& D position) may choose to pursue, either to further their education or to achieve a competitive advantage in the job application process.
NCC Credential in Inpatient Obstetric Nursing (RNC-OB)
This credential can be earned after a nurse has a minimum of two years of OB experience. The test is a competency-based exam that tests OB-specific knowledge. Once earned, the credential must be renewed every 3 years with required continuing education credits completed as well.
Certification in Electronic Fetal Monitoring (C-EFM)
This examination is intended to test the specialty knowledge and knowledge application related to electronic fetal monitoring and interpretation of that data. This certification is maintained on a three years cycle through continuing education.
Neonatal Resuscitation Program® (NRP®)
An NRP certification program combines online testing, case-based simulation, and hands-on simulations, and debriefing. The different testing environment(s) should focus on leadership, communication, and teamwork skills in emergency neonatal situations. An NRP certification is valid for two years.
The world of L&D nursing is a highly specialized position, in which the nurse has the sweet privilege of being able to care for women, men, and their families on some of their very best days. It is not uncommon to find that many nurses who land in OB are extremely passionate and never leave the area of work. If you believe you share this passion, obstetrics and women’s health may be an area that can bring you joy for your whole career.
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